European Radiology

, Volume 27, Issue 12, pp 5024–5033 | Cite as

Multiparametric voxel-based analyses of standardized uptake values and apparent diffusion coefficients of soft-tissue tumours with a positron emission tomography/magnetic resonance system: Preliminary results

  • Koji Sagiyama
  • Yuji Watanabe
  • Ryotaro Kamei
  • Sungtak Hong
  • Satoshi Kawanami
  • Yoshihiro Matsumoto
  • Hiroshi Honda



To investigate the usefulness of voxel-based analysis of standardized uptake values (SUVs) and apparent diffusion coefficients (ADCs) for evaluating soft-tissue tumour malignancy with a PET/MR system.


Thirty-five subjects with either ten low/intermediate-grade tumours or 25 high-grade tumours were prospectively enrolled. Zoomed diffusion-weighted and fluorodeoxyglucose (18FDG)-PET images were acquired along with fat-suppressed T2-weighted images (FST2WIs). Regions of interest (ROIs) were drawn on FST2WIs including the tumour in all slices. ROIs were pasted onto PET and ADC-maps to measure SUVs and ADCs within tumour ROIs. Tumour volume, SUVmax, ADCminimum, the heterogeneity and the correlation coefficients of SUV and ADC were recorded. The parameters of high- and low/intermediate-grade groups were compared, and receiver operating characteristic (ROC) analysis was also performed.


The mean correlation coefficient for SUV and ADC in high-grade sarcomas was lower than that of low/intermediate-grade tumours (−0.41 ± 0.25 vs. −0.08 ± 0.34, P < 0.01). Other parameters did not differ significantly. ROC analysis demonstrated that correlation coefficient showed the best diagnostic performance for differentiating the two groups (AUC 0.79, sensitivity 96.0%, specificity 60%, accuracy 85.7%).


SUV and ADC determined via PET/MR may be useful for differentiating between high-grade and low/intermediate-grade soft tissue tumours.

Key Points

PET/MR allows voxel-based comparison of SUVs and ADCs in soft-tissue tumours.

A comprehensive assessment of internal heterogeneity was performed with scatter plots.

SUVmax or ADCminimum could not differentiate high-grade sarcoma from low/intermediate-grade tumours.

Only the correlation coefficient between SUV and ADC differentiated the two groups.

The correlation coefficient showed the best diagnostic performance by ROC analysis.


PET/MR SUV ADC Soft-tissue tumour Malignancy 


Compliance with ethical standards


The scientific guarantor of this publication is Yuji Watanabe

Conflict of interest

The authors of this manuscript declare relationships with the following companies: Y. Watanabe and S. Kawanami: Bayer Healthcare Japan, Modest, Research Grant; Philips Electronics Japan, Modest, Research Grant.


This study received funding by JSPS KAKENHI Grant Number JP16K19827 and the Fukuoka Foundation for Sound Health Cancer Research Fund.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.


• prospective

• diagnostic

• performed at one institution


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Koji Sagiyama
    • 1
  • Yuji Watanabe
    • 2
  • Ryotaro Kamei
    • 1
  • Sungtak Hong
    • 3
  • Satoshi Kawanami
    • 2
  • Yoshihiro Matsumoto
    • 4
  • Hiroshi Honda
    • 1
  1. 1.Department of Clinical Radiology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  2. 2.Department of Molecular Imaging and Diagnosis, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  3. 3.HealthcarePhilips Electronics JapanTokyoJapan
  4. 4.Departmant of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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